December 2012

Volume 29, Issue 4

Cost-effectiveness models for dental caries prevention programmes among Chilean schoolchildren

Authors: R. Mariño J. Fajardo M. Morgan
doi: 10.1922/CDH_2893Mariño07

Abstract

Aim: This study aims to estimate the cost-effectiveness from a societal perspective of seven dental caries prevention programmes among schoolchildren in Chile: three community-based programmes: water-fluoridation, salt-fluoridation and dental sealants; and four school-based programmes: milk-fluoridation; fluoridated mouthrinses (FMR); APF-Gel, and supervised toothbrushing with fluoride toothpaste. Methods: Standard cost-effectiveness analysis methods were used. The costs associated with implementing and operating each programme, using a societal perspective, were identified and estimated. The comparator was non-intervention. Health outcomes were measured as dental caries averted over a 6-year period. Costs were estimated as direct treatment costs, programmes costs and costs of productivity losses as a result of each dental caries prevention programme. Incremental cost-effectiveness ratios were calculated for each programme. Sensitivity analyses were conducted over key parameters. Results: Primary cost-effectiveness analysis (discounted) indicated that four programmes showed net social savings by the DMFT averted. These savings encompassed a range of values per diseased tooth averted; US$16.21 (salt-fluoridation), US$14.89 (community water fluoridation); US$14.78 (milk fluoridation); and US$8.63 (FMR). Individual programmes using an APF-Gel application, dental sealants, and supervised tooth brushing using fluoridated toothpaste, represent costs for the society per diseased tooth averted of US$21.30, US$11.56 and US$8.55, respectively. Conclusion: Based on cost required to prevent one carious tooth among schoolchildren, salt fluoridation was the most cost-effective, with APF-Gel ranking as least cost-effective. Findings confirm that most community/school-based dental caries interventions are cost-effective uses of society’s financial resources. The models used are conservative and likely to underestimate the real benefits of each intervention. Key words: Fluoride, cost-effectiveness, dental caries prevention, Chile

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Editorial - Do we really need another system for recording caries? Thoughts on ICDAS 258-259 Download
Dental Public Health in Action - Maintaining a survey programme during structural change 260-262 Download
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Recent trends in incidence and mortality of oral and pharyngeal cancer in Schleswig-Holstein in Northern Germany 268-273 Download
A description of oral health in three French jails 274-278 Download
Dental erosion among 12 year-old Libyan schoolchildren 279-283 Download
Children’s views on the experience of a visual examination and intra-oral photographs to detect dental caries in epidemiological studies 284-288 Download
Child dental anxiety, parental rearing style and referral status of children 289-292 Download
Caries status in 16 year-olds with varying exposure to water fluoridation in Ireland 293-296 Download
Caries prevalence in 12-year-old Cypriot children 297-301 Download
Cost-effectiveness models for dental caries prevention programmes among Chilean schoolchildren 302-308 Download
Industry structures in private dental markets in Finland 309-314 Download
Letter from America: UK and US state-funded dental provision 315-320 Download

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